Low Sperm Count: Causes, Symptoms, Treatments

Does having a low sperm count mean that you can’t have a baby? In this blog for Men’s Health Week 2024 (10-16 June) we’re talking all about this common male infertility issue and what you can do about it. As the week’s theme is health checks we’re discussing how to get a sperm test and to encourage more men to seek help if they’re worried about infertility.

What is a low sperm count?

A low sperm count is called oligozoospermia, which means that there are fewer sperm in your semen. According to World Health Organisation guidelines1, a low sperm count is anything below 15 million sperm per ml of semen, or less than 39 million sperm in your ejaculate.

How common is a low sperm count?

Sperm issues are much more common than you might think. Around 1 in 6 couples have difficulty conceiving², with male infertility the cause in up to 50% of cases³. Other common problems with sperm that can cause male infertility include poor sperm motility, abnormally shaped sperm, and producing no sperm at all, which is called azoospermia.

What causes a low sperm count?

Research has shown that the average sperm count has halved worldwide over the past 50 years⁴ and is continuing to decline – and scientists believe that lifestyle and environmental factors are to blame. Obesity, alcohol, smoking, and recreational drug use, along with exposure to certain chemicals and toxins, are all associated with male infertility⁵.

Does a low sperm count mean that I can’t have a baby?

No – a low sperm count does not mean you can’t have a baby. It might just take longer for you to conceive, or you may need help through fertility treatment, depending on your diagnosis.

A low sperm count – along with many other common sperm problems – is a treatable cause of infertility, and even with a low sperm count, many men still manage to conceive naturally⁶. Although your sperm count is important, it does not solely determine your ability to have a baby. Many factors affect your chances of pregnancy where sperm is concerned, such as how well your sperm moves (motility) and if it is shaped normally (morphology).

Symptoms of a low sperm count: How do I know if my sperm count is low?

Many men do not realise they have a sperm problem until they start trying for a baby. If your female partner is under 35 and you have been having regular, unprotected sex for over a year and have not conceived, it’s a good idea for both of you to see your GP or a Fertility Specialist for fertility testing. If your female partner is 35 or over we recommend seeking help and testing after 6 months of trying. For men this involves a sperm check, also called a semen analysis.

Tests for a low sperm count: What is a semen analysis?

If you are advised to have a semen analysis to check your sperm count, it is nothing to worry about. A semen analysis is a simple, non-invasive test where your semen sample is analysed under the microscope in a laboratory. Ideally 2 or 3 days of abstinence is ideal prior to providing the sample. It assesses your sperm count and other key fertility factors, including:

Sperm motility: For natural conception to occur, the sperm must be able to ‘swim’ to the egg. Your sperm are checked to see how well they are moving and if they are showing forward movement.

Sperm morphology: The shape of your sperm matters too, as poor shape can make it harder for the sperm to move correctly and penetrate the egg for fertilisation. Sperm morphology examines the size and shape of the sperm head and tail.

Semen volume: This is how much semen you produce when you ejaculate. It can vary from around 1.5ml to more, depending on the last time you ejaculated and other everyday causes. If your analysis shows a low volume – known as hypospermia – you may need to repeat your semen analysis to check that this is not a consistent issue, as that may indicate a blockage. It is important to stress that the sperm makes up a very small fraction of the sperm volume, the majority is from the secretions from the seminal vesicles and the prostate.

How to improve your sperm count: Lifestyle tips

Living a healthier lifestyle is one of the easiest ways you can try to improve your sperm count and sperm health when you’re trying for a baby. As new sperm is made every three months, lifestyle changes you make now can have a positive impact in a matter of weeks. Avoiding excessive heat to the testes and regular ejaculations can help with healthy sperm production.

The best ways you can help to improve your sperm count include:

Eating a healthy diet
Studies7 have shown that a diet rich in fish, fruit, and vegetables – such as the ‘Mediterranean diet’ – is positively associated with sperm quality. However, a diet rich in processed foods and sugar has a negative impact on sperm quality.

Lowering your BMI
Several studies show that obesity is bad news for sperm health⁸ – with overweight men at significantly increased risk of having a low sperm count compared to men with a normal weight range.

Reducing alcohol intake and quitting smoking
Alcohol and smoking both negatively affect sperm in several ways, according to studies⁹. Smoking, in particular, can reduce sperm count, semen volume, and sperm motility.

Fertility treatments for a low sperm count

If you have a low sperm count and lifestyle changes do not help you to conceive, then fertility treatment is the next step.

ICSI – Intracytoplasmic Sperm Injection – is the most effective treatment for sperm problems. ICSI is very similar to IVF, except that instead of mixing the eggs and sperm, a single, healthy sperm is selected from your semen sample and injected directly into the egg for fertilisation. This overcomes many sperm issues, including a low sperm count.

ICSI is a very successful treatment for male infertility, but it’s important to remember that your chance of success depends on your individual diagnosis and other factors such as your age, your health, and that of your partner. You can learn more about IVF success rates at Adora Fertility clinics here.

For some couples, intra-uterine insemination or IUI is also an option. This is when, at the time of the female partner’s ovulation, a small processed specimen of highly motile sperm in placed through the cervix using a small tube and deposited in the uterus. This treatment is often used to overcome mild sperm abnormalities that are not so severe that the couple requires ICSI.

Support for men with fertility problems

Being told you have a low sperm count – or any sperm issue – can be hard to deal with. But it is nothing to be ashamed of. As you can see from the statistics referenced in this blog, male fertility problems are extremely common and, in many cases, they are treatable.

But it’s good to chat with someone who understands what you’re going through. All Adora Fertility clinics have professional counsellors available as part of your treatment at any stage of your journey. Confidential and private, many men find counselling invaluable. It’s not unusual to feel a sense of ‘blame’ or struggle with anxiety and stress about whether treatment will work.

Our psychologists will help you navigate these normal emotions, giving you reassurance and support so you can look forward to starting your family. Our clinic team is also here to support you. From our Fertility Specialists to our Nurses, we have years of experience helping men with all kinds of fertility problems to become fathers.

Worried about your sperm count? Get help today

If you’re worried about your fertility, or want to arrange a sperm check, talk to our friendly fertility advisors as a first step. We have different ways to get in touch: Choose a no- obligation, confidential phone chat, or email us and we will do the rest.

Alternatively, we have partnered with Sapyen to make semen testing possible in the privacy of your own home. Sapyen’s Test Kit utilises a patent-pending sperm stabilisation medium which ensures the sample remains at the highest quality as it travels from your home via post for testing. Backed by some of the world’s leading Fertility Specialists and with lab quality accuracy, the Sapyen test kit is both convenient and discreet, while also offering privacy and convenience. Order your kit here www.sapyen.co/adora

Sources

World Health Organization reference values for human semen characteristics: https://pubmed.ncbi.nlm.nih.gov/19934213/
WHO: 1 in 6 people globally affected by infertility: https://www.who.int/news/item/04-04-2023-1-in-6-people-globally-affected-by-infertility
Male Infertility: https://pubmed.ncbi.nlm.nih.gov/37709866/
Temporal trends in sperm count: a systematic review and meta-regression analysis of samples collected globally in the 20th and 21st centuries: https://academic.oup.com/humupd/article/29/2/157/6824414
Environmental and Occupational Exposures Associated with Male Infertility: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8265198/
Spontaneous pregnancy in couples waiting for artificial insemination donor because of severe male infertility: https://pubmed.ncbi.nlm.nih.gov/9119099/
How Food Choices Impact on Male Fertility: https://link.springer.com/article/10.1007/s13668-023-00503-x
Obesity and Increased Risk for Oligozoospermia and Azoospermia: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5151180/
Association between socio-psycho-behavioural factors and male semen quality: systematic review and meta-analyses: https://www.fertstert.org/article/S0015-0282(10)00984-2/fulltext